Local Health Departments


Using the instructions and the standing order on this page North Carolina Local Health Departments can bill health care payors for tobacco cessation counseling. Download both documents and follow the instructions to be reimbursed for providing tobacco treatment services.

Dispensing NRT

The NC Board of Pharmacy allows Registered Nurses employed by a North Carolina Local Health Department to dispense over-the-counter nicotine replacement therapy to persons as directed in the Standing Orders below. These nicotine replacement therapies do not require a prescription to be purchased; however, having a prescription for nicotine replacement therapy may facilitate insurance coverage. These products are listed under 21 NCAC 46 .2403 Drugs and Devices to be Dispensed. Only those health departments that have a dispensing pharmacy permit can implement these Standing Orders by nurses who have been trained in nurse dispensing.

Over-the-Counter Nicotine Replacement Therapy and Medicaid

When prescribing or selecting nicotine patches, gum or lozenges for your a patient/client who has Medicaid, be sure and pick a medication with the proper National Drug Code or NDC.

For a list of all Medicaid covered over-the-counter nicotine replacement therapies with NDC codes click here. Any nicotine replacement therapy not on this list, will not be covered by Medicaid. This may cause confusion and result in your patient not receiving their prescribed and covered tobacco pharmacotherapy. To ensure your patient’s/client’s pharmacotherapy is covered:

1. Call the pharmacy and tell them to use one of the nicotine replacement options on the NDC list.
2. Add in the Notes to Pharmacy section of your NRT prescriptions for Medicaid recipients: “Pharmacy - Please fill with a Medicaid-covered NDC. For a current list call NC Tracks at 1-800-688-6696.”